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Query: UMLS:C0155339 (Brown)
 12,436 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An extension of the visual-grid method of controlling egress from a 30-bed specialized dementia care unit of a nursing home was tested. Hussian and Brown (1987) significantly reduced patient egress attempts from a state hospital psychogeriatric ward with strips of beige tape on a brown floor near an opaque door. In this study, black tape was used on a white floor at both glass exit doors, in the same configuration as Hussian and Brown's (1987) most effective condition. Data indicated no intervention effect. Results are attributed mainly to the glass doors, which allow an outdoor view and can entice residents outward and distract them from the floor grid.
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PMID:Two-dimensional grid is ineffective against demented patients' exiting through glass doors. 231 95

Vasopressin (VP) is involved as a neurotransmitter in a number of central functions that are frequently disturbed during aging and dementia. Therefore, this peptide has been used in clinical trials as a 'substitution therapy' for the degenerating peptidergic neurons, aimed at improving cognitive functions in aged and demented individuals with unequivocal results. In order to investigate whether the VP systems indeed show the claimed degenerative changes during aging and dementia, we focused in the first place on the Supra Optic Nucleus (SON) and Para Ventricular Nucleus (PVN). VP cells were identified by means of immunocytochemistry in a series of 32 formalin-fixed human hypothalami, including 4 patients with senile dementia of the Alzheimer type (SDAT). In the SON and PVN, VP cell and nucleolar size was determined by means of a digitizer device, as parameter for peptide synthesizing activity. VP cell size and nucleolar size increased beyond 80 years of age, both in the PVN and in the SON. In SDAT patients these measures fell within the range for their age group. Instead of degenerative changes, these results show an activation of the vasopressinergic system in senescence and in SDAT patients, similar to earlier observations in the aged rat and in accordance with a rise in human neurophysin and VP levels reported recently. The cause for these changes might be in the kidney. Immunocytochemical staining of VP binding sites in the renal tubuli was strongly diminished in kidneys of old (25 and 34 months) as compared to young (3 and 5 months) Wistar and Brown-Norway rats.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Increased vasopressin production in senescence and dementia]. 294 1

Creutzfeldt-Jakob disease (CJD) is caused by an unusual prion protein. Rare CJD cases have been reported in Chinese individuals. This report describes the clinical manifestations of 14 Chinese individuals with clinically definite CJD from the National Taiwan University Hospital during the period 1976-1995. It is the largest case series of Chinese CJD up to now. All these patients fulfil the clinical definite diagnosis of CJD proposed by Brown et al. (1986), including rapidly evolving dementia, myoclonus, periodic electroencephalographic (EEG) activity (0.5-2 Hz) and death within 12 months. The clinical characteristics of the present series, including age at onset, sex ratio, duration, initial symptoms, neurological signs, EEG abnormalities, and neuroimaging studies were similar to those reported in other countries. However, there is a high incidence of initial ataxic gait as the presentation in our patients. Eight (57%) out of 14 patients initially had gait ataxia alone or in association with dementia. CJD should be considered in the differential provisional diagnosis of any middle-aged patient with a progressive ataxic syndrome.
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PMID:Is ataxic gait the predominant presenting manifestation of Creutzfeldt-Jakob disease? Experience of 14 Chinese cases from Taiwan. 886 27

This review of the differential diagnosis of amyotrophic lateral sclerosis focuses on two themes. The first is practical, how to establish the diagnosis based primarily on clinical findings buttressed by electrodiagnosis. The main considerations are multifocal motor neuropathy and cervical spondylotic myelopathy. The second theme is the relationship of motor neuron disease to other conditions, including benign fasciculation (Denny-Brown, Foley syndrome), paraneoplastic syndromes, lymphoproliferative disease, radiation damage, monomelic amyotrophy (Hirayama syndrome), as well as an association with parkinsonism, dementia and multisystem disorders of the central nervous system.
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PMID:Diagnosis of amyotrophic lateral sclerosis. 985 43

Quality of life (QOL) in patients diagnosed with dementia is of critical importance. Reliable and valid measurement of patient QOL is essential to evaluate the effectiveness of treatment interventions and to gain a better understanding of the detrimental impact of dementia on patients' lives. In this study, the psychometric properties of a new scale developed to measure QOL, the Cornell-Brown Scale for Quality of Life, were examined. Data were collected from 50 dementia clinic outpatients with a range of cognitive impairment. Scale ratings were based on a brief, joint interview with caregivers and patients. Findings indicated that the scale demonstrated adequate interrater reliability (intraclass r = 0.90) and internal consistency reliability (Cronbach alpha = 0.81). Criterion validity was indicated by a positive correlation between QOL scores and visual analogue positive mood ratings (Spearman rho = 0.63) and a negative correlation between QOL and dementia severity as measured by Clinical Dementia Ratings (Spearman rho = -0.35). Reliability and validity were not adversely affected by patient cognitive impairment. Thus, preliminary data indicate that the Cornell-Brown Scale for Quality of Life is a brief, easily administered, reliable, and valid measure of QOL.
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PMID:The Cornell-Brown Scale for Quality of Life in dementia. 1204 Mar 6

Dementia is a common and under-diagnosed problem among the elderly. An accurate screening test would greatly aid the ability of physicians to evaluate dementia and memory problems in clinical practice. We sought to determine whether simple and brief psychometric tests perform similarly to the Mini-Mental State Examination (MMSE) in screening for dementia. Using a retrospective analysis, a series of standard, brief, psychometric tests were compared with each other and to the MMSE as screening tests for very mild dementia, using DSM-III-R criterion as the gold standard. Two independent cohorts from the Baltimore Longitudinal Study of Aging and the Washington University Alzheimer's Disease Research Center were evaluated. We found that two brief and simple-to-administer tests appear to offer similar degrees of sensitivity and specificity to the MMSE. These are the recall of a five-item name and address, "John Brown 42 Market Street Chicago" and the one-minute verbal fluency for animals. Combining these two tests further improves sensitivity and specificity, surpassing the MMSE, to detect dementia in individuals with memory complaints.
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PMID:Brief screening tests for the diagnosis of dementia: comparison with the mini-mental state exam. 1576 65

Multi-state models are appealing tools for analysing data about the progression of a disease over time. In this paper, we consider a multi-state Markov chain with two competing absorbing states: dementia and death and three transient non-demented states: cognitively normal, amnestic mild cognitive impairment (amnestic MCI), and non-amnestic mild cognitive impairment (non-amnestic MCI). The likelihood function for the data is derived and estimates for the effects of the covariates on transitions are determined when the process can be viewed as a polytomous logistic regression model with shared random effects. The presence of a shared random effect not only complicates the formulation of the likelihood but also its evaluation and maximization. Three approaches for maximizing the likelihood are compared using a simulation study; the first method is based on the Gauss-quadrature technique, the second method is based on importance sampling ideas, and the third method is based on an expansion by Taylor series. The best approach is illustrated using a longitudinal study on a cohort of cognitively normal subjects, followed annually for conversion to mild cognitive impairment (MCI) and/or dementia, conducted at the Sanders Brown Center on Aging at the University of Kentucky.
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PMID:Shared random effects analysis of multi-state Markov models: application to a longitudinal study of transitions to dementia. 1634 24

Whole-brain irradiation is used for the treatment of brain tumors, but can it also induce neural changes, with progressive dementia occurring in 20-50% of long-term survivors. The present study investigated whether 45 Gy of whole-brain irradiation delivered to 12-month-old Fischer 344 x Brown Norway rats as nine fractions over 4.5 weeks leads to impaired Morris water maze (MWM) performance 12 months later. Compared to sham-irradiated rats, the irradiated rats demonstrated impaired MWM performance. The relative levels of the NR1 and NR2A but not the NR2B subunits of the NMDA receptor were significantly higher in hippocampal CA1 of irradiated rats compared to control rats. No significant differences were detected for these NMDA subunits in CA3 or dentate gyrus. Further analysis of CA1 revealed that the relative levels of the GluR1 and GluR2 subunits of the AMPA receptor and synaptophysin were not altered by whole-brain irradiation. In summary, a clinically relevant regimen of fractionated whole-brain irradiation led to significant impairments in spatial learning and reference memory and alterations in the relative levels of subunits of the NMDA, but not the AMPA, receptors in hippocampal CA1. These findings suggest for the first time that radiation-induced cognitive impairments may be associated with alterations in glutamate receptor composition.
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PMID:Spatial learning and memory deficits after whole-brain irradiation are associated with changes in NMDA receptor subunits in the hippocampus. 1714 74

Patients with mild cognitive impairment and mild to moderate Alzheimer's disease can provide information about their quality of life. This study determined whether aggregating patient and informant quality-of-life reports on the Cornell-Brown Scale for Quality of Life in Dementia can provide a broader perspective on the quality of life relative to patient or informant reports separately. Aggregated Cornell-Brown Scale for Quality of Life in Dementia scores were hypothesized to correlate more strongly with both patient and informant perspectives of patient's memory, function, and neuropsychiatric symptoms than the unaggregated measures. Results indicated that aggregated Cornell-Brown Scale for Quality of Life in Dementia scores reflected a blend of patient and informant perspectives on patient function. This study contributes to a growing line of research that recommends integrating patient and informant perspectives to achieve the most complete assessment of quality of life.
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PMID:Integrating patient and informant reports on the Cornell-Brown Quality-of-Life Scale. 1816 12

This study examined memory and executive functions of switching and distributing attention in 25 Alzheimer patients (AD), 9 patients with frontal variant of frontotemporal dementia (fvFTD), and 25 healthy older people, as a control group, in three tasks: verbal digit span, Brown-Peterson (B-P) task, and dual-task. No differences were found in digit span. Qualitative analysis of errors in the B-P task indicated that both ADs and fvFTDs presented a higher number of omissions and perseverations, interpreted in this study as an index of executive dysfunction, compared to the control group. In fact, the ADs persevered more or the same as the fvFTDs, and no differences were found between the two groups of patients in omissions. The dual-task results showed that both AD and fvFTD had difficulties coordinating the two tasks simultaneously compared to the control group, but no differences were found between the patient groups. Although the presence of alterations in the executive functions of AD patients may suggest that these functions would depend on the correct functional integration of various cerebral areas, it would be of great interest to include neurological evidence in order to contrast these results in future research.
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PMID:A comparison of memory and executive functions in Alzheimer disease and the frontal variant of frontotemporal dementia. 2066 70


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